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May 27, 2011 / Vol. 60 / No. 20

MMWR Introduction

This report examines smoking prevalence and the effects of cigarette package warning labels on interest in quitting among adults who smoke manufactured cigarettes using data from the Global Adult Tobacco Surveys (GATS) conducted from 2008 to 2010 in 14 countries: Bangladesh, Brazil, China, Egypt, India, Mexico, Philippines, Poland, the Russian Federation, Thailand, Turkey, Ukraine, Uruguay and Vietnam. The report finds that adult usage of manufactured cigarettes varied widely and that warnings on cigarette packages prompt smokers to think of quitting. Among men, smoking prevalence ranged from 9.6% (India) to 59.3% (Russian Federation). Among women, prevalence was highest in Poland (22.9%) and less than 2% in Bangladesh, China, Egypt, India, Thailand, and Vietnam. According to the report, the vast majority of men that use manufactured cigarettes noticed package warning labels—more than 90 percent of men in all countries except India (78.4 percent) and Mexico (83.5 percent). Among women, more than 90 percent in seven of the 14 countries reported noticing package warnings, and at least 75 percent in 12 of 14 countries reported noticing a package warning. Among those who noticed package warnings, data suggest that there was substantial interest in quitting because of the warnings. Prominent, pictorial warnings are most effective in communicating the harms of smoking and use of such warnings is strongly encouraged by CDC and the World Health Organization (WHO). At the time the surveys were conducted, five of the 14 countries participating in the survey had adopted pictorial warnings already. Since that time, four additional countries have passed legislation requiring pictorial warnings.